Overweight and obesity may affect the response of asthmatic children to inhaled steroids

According to research presented today (Wednesday) at the "virtual" European Respiratory Society International Conference, children with asthma who are overweight or obese may have a lower response to inhaled steroid drugs, which leads to more frequent asthma attacks

International research is the first to use information on genetic variation and body mass index (BMI) surveys.

Dr.

Treatment guidelines recommend the use of steroids in children with asthma who have a BMI higher than normal

Dr.

Researchers obtain information about the child's age and gender, asthma diagnosis, asthma characteristics (such as medications and recent attacks), BMI, allergies, exposure to harmful environments triggers like smoking, and BMI-related genetic variation states are identified from DNA from blood Extract, saliva, nasal swab samples

They use genetic risk scores to predict increases and decreases in children’s BMI z-scores

Dr.

“Among 1511 children with asthma who took ICS, the average BMI z-score was 0.

"These results indicate that clinicians need to adopt a more personalized approach to treating overweight and obese children

"For children and their parents, our research results reveal why some children did not respond as expected to steroid inhalers, especially after starting treatment, their asthma attacks were more frequent than expected

Limitations of this study include that data from four of the five studies were collected at the same time point, so researchers cannot always determine which comes first: ICS treatment or asthma attack

In a related presentation at the conference, Dr.

"We found that a special variant of the NEGR1 gene is more common in obese children than in non-obese children
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This variant is related to a hormonal dysfunction called leptin, which is responsible for regulating hunger
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This may indicate that leptin dysfunction may be a potential culprit for poor ICS responses in obesity-related asthmatic children," she said
.

Chris Brightling was not involved in the study.
He is the chairman of the Scientific Council of the European Respiratory Society and a professor of respiratory medicine at the University of Leicester in the United Kingdom
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He said: "This is a very good and fascinating study, and its findings are both important and novel
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It sheds light on the complex interactions between genes, weight and response to inhaled corticosteroids, and emphasizes the use of medications The need to integrate with life>
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Policymakers, healthcare providers and families need to do more to address the growing obesity problem among young people
.
"

These studies are: Pharmacogenetics of asthma drugs in children: 2009-2012 PACMAN study in Holland, 2008-2011 Scottish Pediatric Asthma Gene Environment Study (PAGES), Hartford-Puerto Rico (HPR) study in USA, 2009-2010 , German Association for the Study of Clinical Asthma (CLARA) Childhood Asthma Research, 2009-2014, and 1991-1992 Avon Longitudinal Study of Parents and Children (ALSPAC)
.